Abstract: Objective To analyze the epidemiological characteristics, incidence trends, and spatiotemporal clustering of human brucellosis in Changji Hui Autonomous Prefecture (hereafter "Changji Prefecture"), Xinjiang Uygur Autonomous Region, from 2011 to 2023, in order to provide a scientific basis for the prevention and control of the disease. Methods Case data for human brucellosis reported in Changji Prefecture from 2011 to 2023 were collected. Descriptive epidemiological methods were employed to analyze distribution by time, place, and person. Joinpoint regression analysis was utilized to assess long-term incidence trends. Spatial autocorrelation and spatiotemporal scan statistics were applied to explore the spatiotemporal clustering of human brucellosis. Results A total of 8 291 cases of human brucellosis were reported in Changji Prefecture from 2011 to 2023, with an average annual incidence of 45.71 per 100 000 population. Peak incidence occurred between March and August. The overall incidence rate demonstrated an upward trend from 2011 to 2023 (AAPC=32.52%, 95% CI: 27.56%-42.45%). Specifically, the incidence rate increased from 2011 to 2015 (APC=151.88%, 95% CI: 123.90%-214.47%), showed a decreasing trend from 2015 to 2020 (APC=-23.11%, 95% CI: -32.17%- -18.18%), and reverted to an upward trend from 2020 to 2023 (APC = 39.44%, 95% CI: 17.35%-83.62%). The incidence rate in males was higher than in females (P<0.01). Cases were concentrated in the 40-<60 age group (50.79%), with primary occupations being farmers (81.39%) and herdsmen (5.48%). Analysis of spatial distribution revealed that the three counties (cities) with the highest average annual incidence rates were Qitai County (66.00/100 000), Mulei Kazakh Autonomous County (63.61/100 000), and Manas County (58.80/100 000). Spatial autocorrelation analysis indicated that Moran's I values were greater than 0 for each year from 2012 to 2023 (all P<0.05), confirming the existence of spatial clustering. High-High (H-H) clusters were primarily located in Manas and Hutubi counties from 2011 to 2016, shifting to Qitai and Mulei Kazak Autonomous counties from 2017 to 2023. High-Low (H-L) clusters were mainly observed in Manas County and Changji City, Low-High (L-H) clusters in Manas, Hutubi, and Mulei Kazak Autonomous counties, and Low-Low (L-L) clusters were concentrated in Manas County and Changji City. Spatiotemporal scan statistics identified a primary cluster centered in Que'ergou Town, Hutubi County, and two secondary clusters centered in Banjiegou Town and Laoqitai Town of Qitai County, respectively. Conclusion The incidence of human brucellosis in Changji Prefecture is increasing and exhibits significant spatiotemporal clustering. It is imperative to closely monitor the epidemiological trends of brucellosis in both human and animal populations, adjust prevention and control strategies in a timely manner, and enhance surveillance of cases in high-incidence areas and identified hotspots.

Key words: Brucellosis, Epidemiological characteristics, Spatial autocorrelation, Spatiotemporal cluster